Monoclonal antibody analysis of crescentic membranous glomerulonephropathy.
Idiopathic membranous glomerulonephropathy (MG) has a rather benign prognosis. Acute renal failure with cellular crescents superimposed on MG is unusual and its pathogenesis is not fully understood. We report 3 patients with crescentic MG who showed strong glomerular and interstitial infiltration of leukocytes (CD45), T lymphocytes (CD3), helper/inducer T cells (CD4), cytotoxic/suppressor T cells (CD8), and monocyte-macrophages (CD14). A similar number of CD4+ and CD8+ cells contributed to T cellularity within the glomerular tuft, whereas CD4+ cells were predominant over CD8+ cells in the crescents. Intercellular adhesion molecule-1 (ICAM-1) antigens (CD54) were found on renal vascular endothelium, interstitial cellular aggregates and proximal tubular epithelial cells. The case reports illustrate the contribution of macrophages and T cells bearing predominantly CD4+ phenotype to cellular crescents, and the abnormal expression of ICAM-1 antigens on proximal tubular epithelial cells. Both features suggest that cell-mediated immunity may play a role in the transformation of crescentic MG.
Arrizabalaga
P
P
Department of Medicine, University of Barcelona, Spain.
Sans Boix
A
A
Torras Rabassa
A
A
Darnell Tey
A
A
Revert Torrellas
L
L
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000911:Antibodies, Monoclonal; D015703:Antigens, CD / Q000032:analysis; D005260:Female; D015433:Glomerulonephritis, Membranous / Q000276:immunology* / Q000473:pathology; D006801:Humans; D007150:Immunohistochemistry; D018799:Intercellular Adhesion Molecule-1 / Q000032:analysis; D007668:Kidney / Q000276:immunology* / Q000473:pathology; D007962:Leukocytes / Q000473:pathology; D016131:Lymphocyte Subsets; D008297:Male; D008875:Middle Aged
D000911:Antibodies, Monoclonal; D015703:Antigens, CD; D018799:Intercellular Adhesion Molecule-1